Paul was 30 years old when he was interviewed. He had been in and out of homelessness for most of his adult life, but had become a volunteer with the Cyrenians. He was living in a shared house with some other volunteers.

Paul spent much of his childhood in a caravan in Happy Valley, near the sea, with his parents, brothers and sisters. At 21, when he was living with his girlfriend and her parents, his daughter was born. When she was two months old, they were kicked out, and Paul went to

Sontag (1979) wrote about the metaphors we use to describe illness. Metaphors are ways of speaking about something as if it were something else which is imaginatively but not literally applicable, for instance calling a new moon a sickle. Sontag was mainly concerned with life-threatening illnesses such as cancer and AIDS, and how the metaphors we use can serve to stigmatise the sufferers, for instance referring to AIDS as a gay plague. But people use metaphors to explain illness to themselves

There is certainly no shortage of coverage of health topics in the media. Every night television has at least one, and frequently two or three programmes about aspects of health. There are specific programmes about health such as Health Watch, and there are other programmes with a health aspect such as environmental pollution, as well as programmes on the politics of health services such as hospital waiting lists. There is also no shortage of warnings about health. Health can be seen a

This free course, Improving aerobic fitness, provided an introduction to studying Health & Wellbeing. It took you through a series of exercises designed to develop your approach to study and learning at a distance and helped to improve your confidence as an independent learner.

The course has given you an introduction to some of the factors that need to be considered when developing an exercise programme to improve aerobic fitness. The principles of training and FITT apply not on

The recommended duration of an aerobic exercise session is dependent on several factors, such as the participant’s goals and fitness levels, and the intensity of exercise. Obviously, the higher the intensity of the exercise, the shorter will be its duration. The ACSM 2011 position stand recommends 30-60 minutes of purposeful moderate exercise per session, 20–60 minutes of vigorous exercise per session, or 20–60 minutes of a combination of moderate and vigorous exercise per session for h

Exercise intensity refers to the level of effort or workload at which someone should exercise to stimulate an improvement in their fitness. As mentioned in the previous section, to improve aerobic fitness the ACSM recommend moderate and/or vigorous intensity activity for most adults (Garber et al., 2011). Table 1 summarises what moderate and vigorous mean.

Exercise intensity can be measured using either heart rate or the rating of perceived exertion (RPE) method. We will look at each of

In the previous section the principles of training were considered. When designing an exercise session or programme there are four factors that can be manipulated to adjust the training load – frequency (how often), intensity (how hard), time (how long) and type (what mode), which are commonly referred to by the acronym ‘FITT’.

One of the difficulties of the involvement of drug companies in the mental health field is that it produces a conflict of interest. To put it crudely, drug companies rely on a continuing supply of patients to keep them in business. This is not always congruent with people's best interests, as you will see below. Although mental health services are intended to help people experiencing mental distress, they also have other driving forces. The market economy model of provision has encouraged the

In this extract you consider mental health as a business. This is not the way mental health services are usually regarded, as it is more common, at least in the UK, to regard them as public services. However, ideas about being more businesslike in health and social care have gained prominence in recent years. What does being a business, or more businesslike, mean? For one thing, it implies a profit motive: goods or services delivered to make money for private companies and their shareholders.

The origin of the ‘other’ in society is the widespread human tendency to create categories where people who don't fit in can be placed away from the mainstream. Social categories may lead to prejudice and discrimination, but may also lead to the physical separation of people to the margins of that society. Sibley (1995) traces the physical marginalisation of people in what he calls the ‘geographies of exclusion’. Part of the process of exclusion is where the ‘bad’, the ‘mad’ a

This extract has shown that CAM practice raises a variety of ethical issues. Although ethical considerations have different dimensions when applied to CAM, this extract demonstrated that ethical issues – such as consent, competence, boundaries and effective communication – remain central to good practice. CAM practitioners, like all other responsible health care workers, must be taught and encouraged to recognise the ethical dimensions of their work. All practitioners must be accountable

Every therapy needs to have a sound theory underpinning it. Without it, a therapy cannot grow and mature. Research may extend and improve the knowledge base for a given therapy but not all practitioners are willing or able to participate in useful, well designed research. The issues are related to the ethical principles of benefiting (beneficence) and not harming (non-maleficence). Without evidence to support the claims that are being made, how can practitioners be sure that they are doing go

Practitioners must have a sufficient level of competence to benefit users. The proliferation of training bodies, and the diversity of qualifications available, make it harder to know what represents an appropriate standard of pre-registration training or continuing professional development (CPD). Bringing a therapy under a single regulatory body makes it easier to set national educational standards in which diversity can be maintained, but a basic level of competence to practise is ensured. A

Although CAM practitioners’ duties may vary in nature from other health professionals’ duties, the types of ethical concern remain broadly similar. The rest of this extract considers the key ethical areas underpinning standards of best practice in CAM. Although CAM practice varies dramatically in scope, all the issues listed in Author(s):

Do the usual principles underpinning conventional health care ethics provide an adequate or acceptable framework for the discussion of ethics in the CAM relationship? Most bioethics teaching in medical schools in the UK and USA draws on the principles-based approach to considering ethical dilemmas. To recap, the four principles are:

The UK's medical profession is regulated by the General Medical Council (GMC). One of the main ways in which the GMC, and other regulatory bodies, influences its members is through its code of ethics. This sets out broad principles, rather than detailed guidance, for how practitioners should behave in specific circumstances. This is necessary because a practitioner retains individual accountability and ultimate responsibility for decisions taken during professional practice. Not all br